For over 50 years, efforts have been made to develop beneficial glycometabolic support strategies for patients with myocardial ischaemia and infarction. The concept of providing maximal metabolic support to injured myocardial cells is elegant, and has led to relatively simple and low-cost interventions. Glucose–insulin–potassium (GIK) therapy focuses on infusion of high doses of glucose to halt...

Insulin is essential for glucose homeostasis. Insulin/glucose-insulin-potassium (GIK) regimen suppresses the production of tumor necrosis factor-alpha (TNF-alpha), interleukins-6 (IL-6), macrophage migration inhibitory factor (MIF) and other pro-inflammatory cytokines and reactive oxygen species (ROS), enhances the synthesis of endothelial nitric oxide (eNO), and anti-inflammatory cytokines int...

IN 1959 Selyel reported that myocardial resistance to cardiotoxic agents was reduced by intracellu-lar hypokalemia and hypomagnesemia. Resistance was regained when this ionic imbalance was restored. Obstruction of a coronary artery inevitably causes a heterogeneous mixture of normal well-oxygenat-ed, ischemically injured, and dead cells. This zone is biochemically and electrically unstable. Its...

There has been a longstanding interest in the development of metabolic modulations to improve the outcome of myocardial ischemia. The glucose-insulinpotassium (GIK) regimen presents the classic example of such a quest. For more than four decades since GIK was first described, substantial evidence from animal research and small size clinical studies has supported the efficacy of GIK treatment fo...

Concentrations in Heparinized Blood To the Editor: With much interest have we read the important study on the use of glucose-insulin-potassium (GIK) in diabetic patients undergoing coronary artery bypass grafting by Lazar and coworkers.1 A potential mechanism underlying the beneficial effect of GIK administration includes metabolic modulation of (post)ischemic myocardium. Lowering of the plasma...

There has been a longstanding interest in the development of metabolic modulations to improve the outcome of myocardial ischemia. The glucose-insulinpotassium (GIK) regimen presents the classic example of such a quest. For more than four decades since GIK was first described, substantial evidence from animal research and small size clinical studies has supported the efficacy of GIK treatment fo...

Progression to MI occurred in 49% of subjects in the GIK group and in 52% of those in the placebo group (P = 0.28). Thirty-day mortality rates were 4% with GIK and 6% for placebo (P = 0.27). The endpoint of cardiac arrest or hospital mortality significantly favored GIK (4% and 6%, respectively, P = 0.01). Similar patterns were found for patients presenting with STEMI, again with a significant a...

Hyperglycemia, in both diabetic and nondiabetic patients, has a significant negative impact on the morbidity and mortality of patients presenting with an acute myocardial infarction (AMI). Contemporary evidence indicates that persistent hyperglycemia after initial hospital admission continues to exert negative effects on AMI patients. There have been a number of studies demonstrating the benefi...